American Medical News
NEWS IN BRIEF — Posted Feb. 4, 2013
Over a two-year period, Medicare improperly paid $125 million for health services provided to prisoners and people who unlawfully entered the country, federal investigators stated in recent reports.
The Dept. of Health and Human Services Office of Inspector General recommended that the Centers for Medicare & Medicaid Services recoup improper payments for the care provided between 2009 and 2011. Officials also recommended that CMS improve its claims processing systems to detect payments made for services for inmates and illegal immigrants.
Medicare pay totaling $91.6 million was made to health professionals for the care of 2,600 patients because CMS did not receive immigration information for those patients promptly, the OIG said in a Jan. 23 report. An additional 11,600 incarcerated individuals received $33.6 million worth of Medicare services even though the prisons should have covered those expenses, it said in a separate Jan. 23 report.
Medicare does pay medical costs of incarcerated beneficiaries if local law requires patients to repay the costs. Federal law also allows payment for services provided to legal immigrants, but not those who are in the U.S. illegally.